University of Bergen, Norway.
University of Bergen, Norway; Western Norway University of Applied Sciences, Norway; Oslo University Hospital, Norway.
Nurs Ethics. 2020 Jun;27(4):991-1002. doi: 10.1177/0969733019893098. Epub 2020 Jan 27.
Over the last years, there has been a growth in care solutions aiming to support home-dwelling persons with dementia. Assistive technology and voluntarism have emerged as supplements to traditional homecare and daycare centers. However, patient participation is often lacking in decision-making processes, undermining ethical principles and basic human rights.
This study explores the perceptions of persons with dementia toward assistive technology, volunteer support, homecare services, and daycare centers.
A hermeneutical approach was chosen for this study, using a semi-structured interview guide to allow for interviews in the form of open conversations.
Twelve home-dwelling persons with dementia participated in the study. The participants were recruited through municipal daycare centers.
Interviews were facilitated within a safe environment, carefully conducted to safeguard the participants' integrity. The Regional Committee for Medical and Health Research Ethics, Western Norway (Project number 2016/1630) approved the study.
The participants shared a well of reflections on experience and attitudes toward the aspects explored. They described assistive technology as possibly beneficial, but pointed to several non-beneficial side effects. Likewise, they were hesitant toward volunteer support, depending on how this might fit their individual preferences. Homecare services were perceived as a necessary means of care, its benefits ascribed to a variety of aspects. Similarly, the participants' assessments of daycare centers relied on specific aspects, with high individual variety.
The study indicates that the margins between whether these specific care interventions were perceived as supportive or infringing may be small and details may have great effect on the persons' everyday life. This indicates that patient participation in decision-making processes for this group is-in addition to be a judicial and ethical requirement-crucial to ensure adequate care and support.
近年来,旨在为居家痴呆症患者提供支持的护理解决方案不断增加。辅助技术和志愿服务已成为传统家庭护理和日托中心的补充。然而,患者的参与在决策过程中经常缺失,从而破坏了伦理原则和基本人权。
本研究探讨了痴呆症患者对辅助技术、志愿者支持、家庭护理服务和日托中心的看法。
本研究采用解释学方法,使用半结构化访谈指南,允许以开放式对话的形式进行访谈。
12 名居家痴呆症患者参与了这项研究。参与者是通过市立日托中心招募的。
在安全的环境中促进访谈,谨慎进行以保护参与者的完整性。西挪威地区医学和健康研究伦理委员会(项目编号 2016/1630)批准了这项研究。
参与者对所探讨的方面有着丰富的经验和态度的思考。他们认为辅助技术可能有益,但指出了一些非有益的副作用。同样,他们对志愿者支持持犹豫态度,这取决于支持是否符合他们的个人偏好。家庭护理服务被视为必要的护理手段,其益处归因于多个方面。同样,参与者对日托中心的评估依赖于特定的方面,个体差异很大。
研究表明,这些特定的护理干预措施是否被认为是支持性的或侵犯性的,其界限可能很小,细节可能对患者的日常生活产生重大影响。这表明,患者参与这一群体的决策过程不仅是司法和伦理要求,而且对于确保适当的护理和支持至关重要。